Hemoglobin in its biochemical structure is a protein (globin - spherical shape) contained in red blood cells, giving them red blood and serving as a carrier of oxygen and carbon dioxide due to its divalent iron (heme - its part containing iron) .
With a low level of hemoglobin, tissue cells lack oxygen, hypoxia occurs.
The norm of hemoglobin in a newborn
The norm of hemoglobin in a newborn differs significantly from indicators not only in adults, but also in children of other age categories. This is due to the fact that at birth, nutrition is only getting better, the organs and systems of the baby are not yet developed, and a large amount of oxygen is needed for metabolic processes in the baby’s body.
At birth, the hemoglobin index can vary within wide limits: 145-225 g / l. This is a special form of protein - fetal hemoglobin, which is necessary for the baby in the first hours and days of life to maintain all organs and systems until lactation is established and nutrients begin to enter the body of the child. It is characterized by an increased ability to bind and carry oxygen, at the same time it is less resistant to the temperature and acidity of the environment. It makes up 80% of the total hemoglobin in the child's body. By the age of one month, its amount is significantly reduced, and 6 months is almost completely replaced by "adults."
From the time that breastfeeding begins, hemoglobin begins to decline:
• after 2 weeks it is 125-205 g / l;
• in a month - 100-180 g / l;
• after 2 months - 90-140 g / l;
• in a year - 100-140 g / l.
In between, its numbers vary, may be lower or higher. Fetal hemoglobin changes over time to adult hemoglobin.
This process is especially active in the interval between one month and two months of age, when there is a decrease in hemoglobin in the blood of the child to 85-125 g / l. This process is completed by the year when its own hemoglobin begins to be produced.
It is an individual indicator. With the normal course of pregnancy and childbirth, timely lactation, small deviations from the norm in the newborn are not critical.
If the nursing mother has a full and balanced diet, and the baby is applied to the breast upon request, the hemoglobin rate in the newborn will be restored on its own.
If the hemoglobin in the newborn is elevated - what are the causes
In some cases, if the hemoglobin in the newborn is elevated, this is not associated with pathology, but is a variant of the norm in unusual conditions of existence:
• living in the mountains, in thin air conditions, when erythrocytosis is a compensatory reaction to a lack of oxygen;
• a similar mechanism occurs in megacities when the lack of oxygen in the air is due to high gas contamination;
• with a mother who smokes during pregnancy and lactation - in this case, the fetus and the newborn are triggered by protective mechanisms - the production of red blood cells increases;
• dehydration, not associated with a pathological condition, but resulting from insufficient fluid intake.
Diseases - causes of increased hemoglobin in a newborn
If the hemoglobin in the newborn is increased, and there is no tendency to decrease, it can be assumed that this is the result of pathology.
An increase in hemoglobin is not an independent disease, it can be caused by:
• dehydration;
• allergies;
• blood diseases (true polycythemia - Wakez-Osler disease);
• congenital heart defects;
• pulmonary fibrosis;
• cardiopulmonary insufficiency;
• intestinal obstruction;
• oncological pathology;
• high levels of erythropoietin, the hormone of the kidneys responsible for the production of red blood cells.
With erythrocytosis (an increased number of red blood cells and, accordingly, hemoglobin), blood viscosity increases, which causes a violation of its circulation and can lead to the formation of blood clots.
If the hemoglobin in the newborn is increased, the cause is the body’s struggle with the disease, which consists in the supply of a large amount of oxygen to the affected organ: the level of red blood cells, which are oxygen carriers, increases, hemoglobin rises, metabolic processes accelerate.
Symptoms of increased hemoglobin in a newborn
Signs of increased hemoglobin in the newborn are:
• sharp lethargy;
• drowsiness or insomnia;
• decreased or lack of appetite;
• bruising on the skin with slight pressure;
• increase in blood pressure;
• anxiety, moodiness, constant crying associated with headaches in the joints, abdomen;
• skin changes: pallor or hyperemia.
If such symptoms appear in a newborn, it is necessary to consult a pediatrician to examine and determine the causes of increased hemoglobin, and if necessary, to start treatment in a timely manner.
If no pathology is found, it is necessary to establish a drinking regimen, exclude foods with a high iron content from the mother’s diet, and use iron-free mixtures to feed the newborn who is breast-fed.
Causes of low hemoglobin in a newborn
If the hemoglobin in the newborn is reduced, the causes of this condition are associated with pregnancy and childbirth of the nursing mother:
• early toxicosis;
• anemia during pregnancy;
• risk of miscarriage;
• premature birth;
• early aging of the placenta;
• multiple or premature pregnancy;
• entwining the umbilical cord of the fetus or early clamping of the umbilical cord;
• fetal hypoxia.
For reasons causing a decrease in hemoglobin in the newbornalso include some diseases or conditions after certain types of treatment in the mother:
• blood loss and surgery;
• infectious diseases during pregnancy;
• pathology or dysfunction of the kidneys (production of erythropoietin is impaired);
• chemotherapy;
• atypical structure of hemoglobin.
In a healthy child at birth, a decrease in hemoglobin occurs due to malnutrition or inadequate nutrition of the mother (if the newborn is breast-fed) or with improperly selected mixtures for the baby (when it is breast-fed).
Some causes of low hemoglobin levels are:
• deficient conditions when the formation of hemoglobin itself is disturbed or its increased destruction occurs - with a deficiency of iron and B vitamins (folic acid and B12);
• hemolytic conditions that deplete hemoglobin.
In addition, if the hemoglobin in the newborn is lowered, the causes may be associated with diseases that develop in the child:
• constant blood loss associated with ulcerative colitis, diaphragmatic hernia;
• hemorrhagic disease of the newborn;
• hemolytic disease;
• any pathology of the stomach and duodenum, resulting in impaired absorption of iron;
• sepsis, when redistribution of iron occurs;
• connective tissue diseases, in which a significant part of the iron is deposited in other organs;
• congenital heart defects or the development of chronic diseases.
Iron deficiency anemia is the result of reduced hemoglobin in the newborn
If the hemoglobin in a newborn is lowered, the causes listed above lead to iron deficiency anemia. The child changes behavior, appetite, sleep. With this type of anemia, in addition to low hemoglobin, a low level of iron is determined. Approximately 2/3 of its total content are in the composition of hemoglobin, part - is deposited in the liver, spleen, bone marrow, some more is part of the cytochromes that control cellular respiration.
Absorption of iron from breast milk occurs in the small intestine. In products, it is in trivalent (non-absorbable) form. The process of converting it into bivalent, which is easily absorbed, occurs in the stomach, and later in the cells of the intestinal mucosa.
The absorption of iron is affected by the composition of the woman’s food. When dairy products and large amounts of tea are consumed, iron absorption is impaired. Insoluble albuminates are formed with milk, and complexes with tannin, which also do not dissolve.
A decrease in hemoglobin in a newborn develops gradually, proceeds in several stages. In the case when it is associated with iron deficiency, there are distinguished latent and obvious iron deficiency. With a latent lack of clinical manifestations, there may not yet be. It is characterized by changes in the blood test. An obvious flaw is manifested by a vivid clinical picture, a pathological blood test, and changes in internal organs.
Other manifestations of low hemoglobin
With hemolytic disease of the newborn, the destruction of red blood cells occurs, as a result - a sharp decrease in hemoglobin, hyperbilirubinemia, the development of jaundice.
Hemorrhagic disease of the newborn is manifested by increased bleeding due to a lack of coagulation factor, which depends on the amount of vitamin K. It is a severe pathology that can result in hypovolemic shock. Anemia is one of the symptoms of the disease.
Common clinical symptoms of low hemoglobin
The clinical manifestations of iron deficiency anemia include:
• pallor of the skin and mucous membranes;
• lethargy, rapid excitability;
• increased sweating;
• lack of appetite and weight loss;
• drowsiness, insomnia;
• severe dry skin, cracks in the corners of the mouth;
• stool disorders: diarrhea, constipation, flatulence;
• change the nail plate:
• possible increase in temperature.
Hemodynamic disturbances occur, objectively this is manifested:
• lowering blood pressure;
• tachycardia;
• deaf heart sounds;
• systolic murmur;
• valve insufficiency due to low oxygen supply to the myocardium.
Severe anemia is manifested by signs of heart failure, in which edema, weight loss, shortness of breath, severe weakness develop. If treatment is not started on time, brain hypoxia develops: lethargy, drowsiness, delayed reactions and decreased reflexes increase.
How to increase low hemoglobin in a newborn
If the hemoglobin in the newborn is reduced, what to do in each specific case can only be decided by the doctor after examining and examining the child. Treatment for low hemoglobin in an infant includes:
• correction of food products of a nursing mother;
• changing the mixture for nutrition in case of artificial feeding;
• drug treatment with iron preparations (Maltofer, Sorbifer, Actiferin, Tardiferon, Feroplex);
• use of multivitamins.
Treatment with preparations containing iron continues until the normalization of hemoglobin and blood color. Upon reaching the norm, it is necessary for several months to continue therapy with a half dose of the same drug that was prescribed for the drug course.
A diet rich in iron is a mandatory part of therapeutic measures. A lactating woman should include meat, green vegetables in her daily diet. A child who is breast-fed is prescribed a mixture containing iron.
Complex multivitamin preparations approved for newborns are used at the stage of maintenance therapy with iron.
Correction of low hemoglobin should begin as early as possible, since a sufficient amount of oxygen is required for the normal growth and development of the child's body. Timely contacting a pediatrician will help to solve problems with low hemoglobin and prevent serious complications.
